Robert Allen Lea, LPC, MA
Individual provider Active NPI Professional Counselor · Kingfisher, OK
NPI 1922433481 · NPPES record last updated Mar 24, 2022
Key facts
- NPI
- 1922433481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- R3084 (OR)
- Practice address
- 107 N Main St
Kingfisher, OK 73750-2730 - Phone
- (405) 424-7711
- NPI assigned
- Sep 3, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231221003140 | OK | Practitioner - Mental Health Counselor | 5991155566 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R3084 | OR | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oklahoma Mental Health Council | Current |
Accepting new patients | |
| Oklahoma Mental Health Council | Current | Accepting new patients |
Locations
4400 N Lincoln Blvd
Oklahoma City, OK 73105
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | R3084 | OR | Yes |
Addresses
Primary practice location
107 N Main St
Kingfisher, OK 73750-2730
Mailing address
5224 Spinnaker PT
Edmond, OK 73013-8650
Phone (541) 337-2486
Other providers in Kingfisher, OK
- Kingfisher Regional Hospital
- Chasity Kirkman
- Cynthia Knapski
- Katherine A Kroener
- Kadriye Ann Landis
- Brooklynn S Licastro
- Kelly A Lingo
- Lisa Matson MD PLLC
- Sharris Loewen
- Madeline Loosen
All providers in Kingfisher, OK · Professional Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.